Fermi Matteo, Liberale Carlotta, Molteni Gabriele
Department of Otorhinolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - Università di Bologna, Bologna.
Curr Opin Otolaryngol Head Neck Surg. 2025 Apr 1;33(2):74-78. doi: 10.1097/MOO.0000000000001029. Epub 2024 Dec 19.
The aim of this review is to investigate the most suitable surgical approach to managing parapharyngeal space (PPS) squamous cell carcinoma (SCC) metastasis.
SCC metastasis in PPS are extremely rare. The PPS itself is a complex anatomical area, requiring extensive surgical experience and various surgical approaches for effective management. Several authors have attempted to systematize the surgical approaches to the PPS based on the anatomical location and histological nature of the lesions. However, there are currently few studies in the literature on the specific management of SCC metastases in the PPS, as these lesions are extremely rare.
The treatment of SCC metastases in the PPS must be determined based on the individual patient. If the patient is a candidate for surgery, the surgical approach should be chosen based on the location of the metastases and must ensure a sufficiently wide surgical corridor to allow for as complete a resection as possible. To date, the surgical approach that best meets these requirements is the transcervical transparotid approach. With new technologies, including the use of robotics and endoscopy, surgery can become increasingly less invasive while maintaining the wide exposure provided by open surgical procedures.
本综述旨在探讨管理咽旁间隙(PPS)鳞状细胞癌(SCC)转移最合适的手术方法。
PPS中的SCC转移极为罕见。PPS本身是一个复杂的解剖区域,需要丰富的手术经验和多种手术方法才能有效处理。几位作者试图根据病变的解剖位置和组织学性质将PPS的手术方法系统化。然而,目前关于PPS中SCC转移的具体处理的文献研究很少,因为这些病变极为罕见。
PPS中SCC转移的治疗必须根据个体患者来确定。如果患者适合手术,手术方法应根据转移灶的位置选择,并且必须确保足够宽的手术通道,以尽可能完整地切除。迄今为止,最符合这些要求的手术方法是经颈透明腮腺入路。随着包括机器人技术和内窥镜检查在内的新技术的出现,手术在保持开放手术所提供的广泛暴露的同时,可以越来越微创。